دورية أكاديمية
Ischaemic electrocardiogram patterns and its association with survival in out-of-hospital cardiac arrest patients without ST-segment elevation myocardial infarction: a COACT trials' post-hoc subgroup analysis.
| العنوان: | Ischaemic electrocardiogram patterns and its association with survival in out-of-hospital cardiac arrest patients without ST-segment elevation myocardial infarction: a COACT trials' post-hoc subgroup analysis. |
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| المؤلفون: | Spoormans EM; Department of Cardiology, Amsterdam University Medical Centre, location VUmc, ZH 5F 19, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands., Lemkes JS; Department of Cardiology, Amsterdam University Medical Centre, location VUmc, ZH 5F 19, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands., Janssens GN; Department of Cardiology, Amsterdam University Medical Centre, location VUmc, ZH 5F 19, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands., Soultana O; Department of Cardiology, Amsterdam University Medical Centre, location VUmc, ZH 5F 19, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands., van der Hoeven NW; Department of Cardiology, Amsterdam University Medical Centre, location VUmc, ZH 5F 19, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands., Jewbali LSD; Department of Cardiology, Erasmus Medical Centre, Rotterdam, The Netherlands., Dubois EA; Department of Cardiology, Erasmus Medical Centre, Rotterdam, The Netherlands.; Department of Intensive Care Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands., Meuwissen M; Department of Cardiology, Amphia Hospital, Breda, The Netherlands., Rijpstra TA; Department of Intensive Care Medicine, Amphia Hospital, Breda, The Netherlands., Bosker HA; Department of Cardiology, Rijnstate Hospital, Arnhem, The Netherlands., Blans MJ; Department of Intensive Care Medicine, Rijnstate Hospital, Arnhem, The Netherlands., Bleeker GB; Department of Cardiology, HAGA Hospital, Den Haag, The Netherlands., Baak R; Department of Intensive Care Medicine, HAGA Hospital, Den Haag, The Netherlands., Vlachojannis GJ; Department of Cardiology, Maasstad Hospital, Rotterdam, The Netherlands.; Department of Cardiology, University Medical Centre Utrecht, Utrecht, The Netherlands., Eikemans BJW; Department of Intensive Care Medicine, Maasstad Hospital, Rotterdam, The Netherlands., van der Harst P; Department of Cardiology, University Medical Centre Utrecht, Utrecht, The Netherlands.; Department of Cardiology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands., van der Horst ICC; Department of Intensive Care Medicine, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.; Department of Intensive Care Medicine, Maastricht University Medical Centre, University Maastricht, Maastricht, The Netherlands., Voskuil M; Department of Cardiology, University Medical Centre Utrecht, Utrecht, The Netherlands., van der Heijden JJ; Department of Intensive Care Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands., Beishuizen A; Intensive Care Centre, Medisch Spectrum Twente, Enschede, The Netherlands., Stoel M; Department of Cardiology, Medisch Spectrum Twente, Enschede, The Netherlands., Camaro C; Department of Cardiology, Radboud University Medical Centre, Nijmegen, The Netherlands., van der Hoeven H; Department of Intensive Care Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands., Henriques JP; Department of Cardiology, Amsterdam University Medical Centre, location AMC, Amsterdam, The Netherlands., Vlaar APJ; Department of Intensive Care Medicine, Amsterdam University Medical Centre, location AMC, Amsterdam, The Netherlands., Vink MA; Department of Cardiology, OLVG, Amsterdam, The Netherlands., van den Bogaard B; Department of Intensive Care Medicine, OLVG, Amsterdam, The Netherlands., Heestermans TACM; Department of Cardiology, Noord West Ziekenhuisgroep, Alkmaar, The Netherlands., de Ruijter W; Department of Intensive Care Medicine, Noord West Ziekenhuisgroep, Alkmaar, The Netherlands., Delnoij TSR; Department of Intensive Care Medicine, Maastricht University Medical Centre, University Maastricht, Maastricht, The Netherlands., Crijns HJGM; Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands., Oemrawsingh PV; Department of Cardiology, Haaglanden Medical Centre, Den Haag, The Netherlands., Gosselink MTM; Department of Cardiology, Isala Hospital, Zwolle, The Netherlands., Plomp K; Department of Cardiology, Tergooi Hospital, Blaricum, The Netherlands., Magro M; Department of Cardiology, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands., Elbers PWG; Department of Intensive care medicine, Amsterdam University Medical Centre, location VUmc, Amsterdam, The Netherlands., van de Ven PM; Department of Epidemiology and Data Science, Amsterdam University Medical Centre, location VUmc, Amsterdam, The Netherlands., van Royen N; Department of Cardiology, Amsterdam University Medical Centre, location VUmc, ZH 5F 19, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.; Department of Cardiology, Radboud University Medical Centre, Nijmegen, The Netherlands. |
| المصدر: | European heart journal. Acute cardiovascular care [Eur Heart J Acute Cardiovasc Care] 2022 Jul 21; Vol. 11 (7), pp. 535-543. |
| نوع المنشور: | Clinical Trial; Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Oxford University Press Country of Publication: England NLM ID: 101591369 Publication Model: Print Cited Medium: Internet ISSN: 2048-8734 (Electronic) Linking ISSN: 20488726 NLM ISO Abbreviation: Eur Heart J Acute Cardiovasc Care Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2021- : [Oxford] : Oxford University Press Original Publication: London : SAGE Publications, 2012- |
| مواضيع طبية MeSH: | Out-of-Hospital Cardiac Arrest*/therapy , ST Elevation Myocardial Infarction*, Coronary Angiography/methods ; Electrocardiography/methods ; Humans ; Troponin T |
| مستخلص: | Aims: ST-depression and T-wave inversion are frequently present on the post-resuscitation electrocardiogram (ECG). However, the prognostic value of ischaemic ECG patterns is unknown. Methods and Results: In this post-hoc subgroup analysis of the Coronary Angiography after Cardiac arrest (COACT) trial, the first in-hospital post-resuscitation ECG in out-of-hospital cardiac arrest patients with a shockable rhythm was analysed for ischaemic ECG patterns. Ischaemia was defined as ST-depression of ≥0.1 mV, T-wave inversion in ≥2 contiguous leads, or both. The primary endpoint was 90-day survival. Secondary endpoints were rate of acute unstable lesions, levels of serum troponin-T, and left ventricular function. Of the 510 out-of-hospital cardiac arrest patients, 340 (66.7%) patients had ischaemic ECG patterns. Patients with ischaemic ECG patterns had a worse 90-day survival compared with those without [hazard ratio 1.51; 95% confidence interval (CI) 1.08-2.12; P = 0.02]. A higher sum of ST-depression was associated with lower survival (log-rank = 0.01). The rate of acute unstable lesions (14.5 vs. 15.8%; odds ratio 0.90; 95% CI 0.51-1.59) did not differ between the groups. In patients with ischaemic ECG patterns, maximum levels of serum troponin-T (μg/L) were higher [0.595 (interquartile range 0.243-1.430) vs. 0.359 (0.159-0.845); ratio of geometric means 1.58; 1.13-2.20] and left ventricular function (%) was worse (44.7 ± 12.5 vs. 49.9 ± 13.3; mean difference -5.13; 95% CI -8.84 to -1.42). Adjusted for age and time to return of spontaneous circulation, ischaemic ECG patterns were no longer associated with survival. Conclusion: Post-arrest ischaemic ECG patterns were associated with worse 90-day survival. A higher sum of ST-depression was associated with lower survival. Adjusted for age and time to return of spontaneous circulation, ischaemic ECG patterns were no longer associated with survival. (© The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology.) |
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| معلومات مُعتمدة: | Netherlands Heart Institute, Biotronik, and AstraZeneca |
| فهرسة مساهمة: | Keywords: Cardiac arrest; ECG; Ischaemia; Left ventricular function; Shockable rhythm |
| المشرفين على المادة: | 0 (Troponin T) |
| تواريخ الأحداث: | Date Created: 20220603 Date Completed: 20220725 Latest Revision: 20220727 |
| رمز التحديث: | 20240628 |
| مُعرف محوري في PubMed: | PMC9302930 |
| DOI: | 10.1093/ehjacc/zuac060 |
| PMID: | 35656797 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 2048-8734 |
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| DOI: | 10.1093/ehjacc/zuac060 |